Thursday, August 20, 2009

How to get health-care reform on track -- Aug. 20, 2009 column

Several smart journalists were on a public radio talk show the other day, calmly and dispassionately discussing health-care reform, when something surprising happened.

A man who had lost his insurance called, and he was angry. These panelists all have coverage, he said, and they can’t possibly understand how the issue affects people who don’t.

After the tiniest pause, the host invited the caller to tell his story. It was too late; he had already hung up. The host clucked that the man should have used his moment to enlighten the world, but I could understand his frustration.

In this cantankerous summer of shouting matches and gun-toting creeps at health-care town halls, it often seems that the uninsured, the people who will be most affected by health-care reform, either have been used as props or simply ignored. Even their numbers are in dispute. Is it 46 million or half that?

Furious speakers at congressional town hall meetings rage against losing their current benefits and raise the specter of Big Brother and “death panels.” Congressmen worry about next year’s elections. President Obama talks about curbing costs when he could be fostering a can-do, we’re-all-in-this-together attitude.

Change as big as health-care reform is about more than dollars and deficits and heartless bureaucrats and insurance companies. It’s about the kind of country we want.

It’s not too late for the president to use his bully pulpit to set a new tone and lead a discussion about our moral responsibilities to our fellow citizens. Oddly, it has taken until this week for the president to raise the moral imperative, which he did in calls with liberal religious leaders.

As Obama wrestles with congressional Democrats to pass reform in the fall, he and his advisers should remember what attracted voters. Candidate Obama said health care should be the right of every American.

During the second presidential debate last fall, NBC newsman Tom Brokaw asked candidates John McCain and Obama if health care is “a privilege, a right or a responsibility.”

“I think it’s a responsibility, in this respect, in that we should have available and affordable health care to every American citizen, to every family member. … But government mandates I — I’m always a little nervous about. But it is certainly my responsibility,” McCain said.

Obama replied crisply, “Well, I think it should be a right for every American.”

He continued, “In a country as wealthy as ours, for us to have people who are going bankrupt because they can't pay their medical bills -- for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they're saying that this may be a pre-existing condition and they don't have to pay her treatment, there's something fundamentally wrong about that.”

Obama won with a vision of change that lifted up all Americans. Now is not time for the country to wallow in an every-man-for-himself mentality.

But this summer, health-care reform has been about self-interest. The people who complain loudest against a government takeover and socialized medicine already have health insurance. They don’t need a government option.

The White House may jettison the public option so that some sort of bipartisan reform can pass. That’s politics, but to win Democratic support, the final bill needs to include a way to ensure coverage for citizens who lack insurance. That’s more than a political reality. Without such a measure, we risk rising social insecurity and distrust in institutions.

I’ve been surprised by the level of cynicism in the mail I receive from readers, and I’ll write more about that soon. For now, let’s say that many people have lost their faith in politicians, government and the chattering class.

After all, the so-called government experts who tell us the economy is on the mend all have jobs and health insurance. The pundits and professors who say we should rethink the American dream of home ownership and be satisfied with renting? They own their own homes – and have jobs and health insurance.

Empathy got a bad name during the confirmation hearings for Supreme Court justice Sonia Sotomayor, but the angry radio caller was right to want a seat at the table for those who will be most affected by what happens in Washington.